Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.
BMC Ophthalmol. 2024 May 31;24(1):231. doi: 10.1186/s12886-024-03474-x.
The main purpose of this paper is to introduce a method that can accurately locate the posterior capsule of the lens to facilitate a relatively complete resection of the anterior vitreous body.
A total of 51 patients in the experimental group and control group were enrolled in this study. Phacoemulsification combined with vitrectomy was performed in all cases. After the cataract procedure was completed in the control group, the surgeon performed a conventional anterior vitrectomy with the operative eye. In the experimental group, anterior vitrectomy was performed according to the threadiness corrugation of the posterior capsule of the lens. During the operation, with the help of triamcinolone, two surgeons confirmed the resection of the anterior vitreous cortex; the best corrected visual acuity and intraocular pressure of all patients were recorded at 1 week, 1 month and 3 months after surgery.
Fifty patients underwent phacoemulsification combined with vitrectomy, except one patient in the experimental group who was lost to follow-up. After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. There was no significant difference in preoperative visual acuity between the two groups (t = 0.83, P = 0.25). Both groups had varying degrees of improvement in best corrected visual acuity at 1 week, 1 month and 3 months after surgery. Moreover, there was no significant difference in BCVA between the two groups at the three follow-up time points (t=-1.15, -1.65, -1.09, P = 0.53, 0.21, 0.23). After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. Incomplete resection of the anterior vitreous cortex was observed in 2 patients in each group, but there was no significant difference (χ = 7.81, P > 0.05).
In the process of cataract surgery combined with vitrectomy, thready corrugation appears in the posterior capsule of the lens and is an important sign of its localization. Anterior vitrectomy can be accomplished safely and effectively with the help of thread-like corrugation, and the surgical effect is almost the same as that of traditional surgery. Especially suitable for beginners in vitreous surgery.
本文主要介绍一种能准确定位晶状体后囊的方法，以帮助相对完整地切除前部玻璃体。
本研究共纳入实验组和对照组各 51 例患者。所有病例均行白内障超声乳化联合玻璃体切除术。在对照组中，白内障手术后，手术医生在术眼行常规前部玻璃体切除术。在实验组中，根据晶状体后囊的线状皱襞行前部玻璃体切除术。手术过程中，在曲安奈德的帮助下，两位医生确认切除前部玻璃体皮质；术后 1 周、1 个月和 3 个月记录所有患者的最佳矫正视力和眼压。
除实验组 1 例患者失访外，其余 50 例患者均行白内障超声乳化联合玻璃体切除术。术后所有患者除对照组 2 例患者一过性眼压升高外，均未出现明显并发症。两组患者术前视力比较差异无统计学意义（t=0.83，P=0.25）。两组患者术后 1 周、1 个月和 3 个月最佳矫正视力均有不同程度提高，且两组各随访时间点 BCVA 比较差异均无统计学意义（t=-1.15、-1.65、-1.09，P=0.53、0.21、0.23）。术后所有患者除对照组 2 例患者一过性眼压升高外，均未出现明显并发症。两组均有 2 例患者前部玻璃体皮质切除不完全，但差异无统计学意义（χ²=7.81，P＞0.05）。
在白内障手术联合玻璃体切除术中，晶状体后囊出现线状皱襞是其定位的重要标志。借助线状皱襞可安全、有效地完成前部玻璃体切除术，其手术效果与传统手术基本相同。尤其适合玻璃体手术初学者。
